Making a move: care-home residents' experiences of relocation

Abstract

Studies in environmental gerontology have progressed our understanding of the ways in which older people respond to and manage the environments in which they live, including their decisions about relocation and the influencing factors. Much of this work, however, has been done with relatively healthy and mobile older people living in domestic environments. It is often the case that when care-home residents move, the decisions are taken by others while the residents are passive and maybe hardly consulted. Far from the residents' preferences and initiatives being instrumental, they are moved by imposition. In the United Kingdom, the setting of this study, such imposed moves are common, partly because registration regulations restrict the range of care that a home can provide, and make some moves unavoidable. A questionnaire was distributed to care homes in two English local authorities to determine the incidence of relocation, and 10 homes were approached to take part in further studies, which included case-note audits, and interviews with staff and 12 older people who had relocated. The study found that the pattern of moves was complex, and that some residents were active in deciding to relocate and in the selection of the relocation home. The study concludes, however, that for residents to have an active role, they must be given support both to access the information required for decision-making and to implement their decisions.

Negotiating and effectuating relocation to sheltered housing in old age: a Swedish study over 11 years

“…Some individuals consciously aim at decreasing environmental press by changes in their physical home environment to stay as independent as possible, for as long as possible. Very old people seem to be aware of the environmental press of their home environment in relation to health, and decisions on relocation can be seen as actions to change the environment to accommodate to health changes that cannot be overcome in the present home (Chen and Wilmoth 2004;Reed et al 2003). Positive effects among older people relocating to sheltered housing have been demonstrated by others as well (Chen and Wilmoth 2004;Svidén et al 2002), while the current study adds to our knowledge of the role of home and health dynamics.…”

“…In other words, in very old age the relationship between housing and health is significant due to the increased vulnerability to environmental challenges ). Thus, relocation can be seen as an action to change the social and physical environment, taken in order to accommodate to health changes that cannot be overcome in the present home (Chen and Wilmoth 2004;Reed et al 2003), while recent empirical evidence for such mechanisms is scarce.…”

Reasons for Relocation to Retirement Communities

“…Previous research has suggested that elders' ability to view relocation as voluntary, desirable, or important has been critical in the process of adjustment (Chen et al, 2007;Johnson & Hlava, 1994;Porter & Clinton, 1992;Prager, 1986;Thomas & Hayley, 1991). Therefore, interventions should be directed toward enhancing pulling factors through helping elders to become familiar with the facility by encouraging a site visit to the facility before they move, helping them to develop relationships with other residents who already live there, and helping them to evaluate the care that is available and to engage in the facility's activities to increase their feelings of security and increase their socialization (Oldman & Quilgars, 1999;Reed, Cook, & Stanley, 1999;Reed, Cook, Sullivan, & Burridge, 2003). Other interventions could include showing the elders a video that describes the facility if they cannot come to visit, individual counseling and group discussion with family members (which can be important for some residents), and helping elders to express their feelings toward the move; these would contribute to more security.…”

Listening to the voices of abused older people: should we classify system abuse?

“…For example, studies on pressures to speed up discharge have shown that they may inadvertently lead to higher mortality risks and have exposed the lack of involvement of older people in decisions to move to residential care. [40][41][42][43] Systemic nature of abuse How can we acknowledge these views? We need to ensure that the voices of older people are heard and their experiences find resonance.…”